JACKSON HOSPITAL AND CLINIC INC. (NPI# 1528449386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528449386 |
| Entity Type | Organization |
| Organization Name | JACKSON HOSPITAL AND CLINIC INC. |
| Other Organization Name | JACKSON CLINIC UROLOGY DME |
| Practice Address |
1722 Pine St Suite 502 Montgomery AL 36106-1103 |
| Practice Telephone | 3342402337 |
| Practice Fax Number | 3342936859 |
| Mailing Telephone | 3342402337 |
| Mailing Fax Number | 3342936859 |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2016-08-22 |
| Authorized Official Name | MICHAEL RITZUS (VICE PRESIDENT PHYSICIAN SERVICES) |
| Authorized Official Telephone | 3342402337 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Jackson Clinic Urology DME | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194256438 | Jackson Hospital and Clinic Inc. | Surgery | 1722 Pine St Ste 201, Montgomery, AL 36106-1158 | 2017-03-27 |
| 1053844654 | Jackson Hospital and Clinic Inc. | Urology | 515 Hospital Dr, Suite A, Wetumpka, AL 36092-1626 | 2017-04-10 |
| 1578003745 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 406, Montgomery, AL 36106-1127 | 2017-03-07 |
| 1841736683 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1722 Pine St, Suite 204, Montgomery, AL 36106-1103 | 2017-01-18 |
| 1194261669 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1758 Park Pl, Suite 402, Montgomery, AL 36106-1127 | 2017-01-09 |
| 1376097089 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1722 Pine St, Suite 406, Montgomery, AL 36106-1103 | 2016-08-10 |
| 1588011746 | Jackson Hospital and Clinic Inc. | Surgery | 1801 Pine St, Suite 101, Montgomery, AL 36106-0165 | 2016-05-18 |
| 1164878856 | Jackson Hospital and Clinic Inc. | Internal Medicine | 461 E Main St, Prattville, AL 36067-3409 | 2016-05-11 |
| 1811350390 | Jackson Hospital and Clinic Inc. | Internal Medicine | 124 S Memorial Dr, Prattville, AL 36067-3619 | 2016-04-01 |
| 1023317666 | Jackson Hospital and Clinic Inc. | Family Medicine | 1801 Pine Street, Suite 103, Montgomery, AL 36106-1160 | 2011-03-22 |
| Street Address |
1722 PINE ST SUITE 502 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36106-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316949472 | Aubrey Ayers Stabler Jr. | Otolaryngology | 1722 Pine St, Suite 804, Montgomery, AL 36106-1108 | 2005-06-02 |
| 1609435155 | Virginia Mcdaniel | Nurse Practitioner | 1722 Pine St, Montgomery, AL 36106-1103 | 2019-06-09 |
| 1841736683 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1722 Pine St, Suite 204, Montgomery, AL 36106-1103 | 2017-01-18 |
| 1376097089 | Jackson Hospital and Clinic Inc. | Internal Medicine | 1722 Pine St, Suite 406, Montgomery, AL 36106-1103 | 2016-08-10 |
| 1407300304 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Suite 904, Montgomery, AL 36106-1103 | 2016-08-09 |
| 1619352895 | Tammie Holcey | Nurse Practitioner | 1722 Pine St, Suite 1005, Montgomery, AL 36106-1103 | 2015-07-29 |
| 1285030080 | Greater Montgomery Patient Centered Gastroenterology and Hepatology | Internal Medicine | 1722 Pine St, Suite 801, Montgomery, AL 36106-1103 | 2014-11-06 |
| 1396152823 | S Louis Armstrong Md PC | Surgery | 1722 Pine St, Suite 201, Montgomery, AL 36106-1103 | 2014-07-16 |
| 1154669752 | Jackson Hospital and Clinic Inc | Surgery | 1722 Pine St, Ste 503, Montgomery, AL 36106-1103 | 2013-01-17 |
| 1033467196 | Jacquelin Ratunil Chua | Internal Medicine | 1722 Pine St, Montgomery, AL 36106 | 2012-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747205 | Rural Urgent Care LLC | Clinic/Center | 3039 Vaughn Road, Montgomery, AL 36106 | 2020-07-16 |
| 1548733306 | Bennett Family Dentistry, LLC | Dentist | 4270 Carmichael Road, Montgomery, AL 36106 | 2019-01-04 |
| 1588133854 | Lori Leanne Fail | Physical Therapist | 1615 Windsor Hill Court, Montgomery, AL 36106 | 2018-11-16 |
| 1073020749 | Charlene Richmond Harrell | Chiropractor | 2900 Zelda Rd., Suite A, Montgomery, AL 36106 | 2018-01-03 |
| 1780123109 | Montgomery Accident and Injury Center, Inc | Nurse Practitioner | 2900 Zelda Rd, Ste B, Montgomery, AL 36106 | 2017-02-17 |
| 1467843573 | Ernest Porterfield | Non-emergency Medical Transport (VAN) | 4183 Carmichael Road, Suite A, Montgomery, AL 36106 | 2015-02-11 |
| 1114334281 | Daniel Gerald O'bryant | Specialist/Technologist | 1160 Navarro Avenue, Montgomery, AL 36106 | 2014-07-21 |
| 1801213764 | Amanda Hodge | Specialist/Technologist | 4605 Cherry Tree Terrace, Montgomery, AL 36106 | 2014-03-27 |
| 1871861542 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1758 Park Pl Ste 102, Montgomery, AL 36106 | 2011-12-08 |
| 1578862546 | Helping Hands Preventitive Health Center | Community/Behavioral Health | 2015 Mulberry St, Montgomery, AL 36106 | 2011-03-16 |
| Find all providers in zip 36106 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1487278917 | Hughston Medical Group, PC | Durable Medical Equipment & Medical Supplies | 2257 Taylor Rd Ste 100, Montgomery, AL 36117-7797 | 2020-06-01 |
| 1710532684 | Knee Scooters Houston LLC | Durable Medical Equipment & Medical Supplies | 9937 Chestnut Ct, Montgomery, TX 77316 | 2019-08-07 |
| 1992299549 | Four Seasons Healthcare Group, Inc | Durable Medical Equipment & Medical Supplies | 500 Interstate Park Drive, Suite 534, Montgomery, AL 36109 | 2018-06-18 |
| 1487156188 | Compression Health Solutions, Inc. | Durable Medical Equipment & Medical Supplies | 15260 Highway 105 W Ste 220, Montgomery, TX 77356-5259 | 2018-03-08 |
| 1447763578 | Rebuild Medical Inc | Durable Medical Equipment & Medical Supplies | 500 Interstate Park Dr Ste 532, Montgomery, AL 36109-5487 | 2017-11-11 |
| 1194251025 | Home Sleep Testing Inc. | Durable Medical Equipment & Medical Supplies | 433 Saint Lukes Dr Ste A, Montgomery, AL 36117-7107 | 2017-05-11 |
| 1174064307 | Knee Scooters Houston, LLC | Durable Medical Equipment & Medical Supplies | 20127 N Shore Dr, Montgomery, TX 77356-2106 | 2017-03-20 |
| 1891153284 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 8035 Vaughn Road, Montgomery, AL 36116 | 2016-02-01 |
| 1285005819 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1600 Federal Dr, Montgomery, AL 36107-1128 | 2015-10-08 |
| 1114302122 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 2180 Woodforest Parkway N, Montgomery, TX 77316 | 2015-07-21 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36106 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.